(Last Updated 8/23/2021)
Proving eligibility for Medicaid means checking every box to establish eligibility under the class of assistance the applicant seeks. The basic requirements are discussed in this chapter. Although financial eligibility criteria are a significant part of the planning and application process, they are discussed in later chapters.
- Section 1: Aged, Blind or Disabled
- Section 2: Categorial Eligibility
- Section 2.1: More on Citizenship
- Section 2.2: More on State of Residence
- Section 3: Medical Eligibility
BLOG POSTS
Updated Georgia Penalty Divisor Effective April 1, 2024
Effective April 1, 2024, the statewide averaged nursing facility private pay rate used in determining the penalty period for institutionalized individuals (nursing facility and home and community-based waiver programs) who transfer assets for less than the fair market value will increase from $9,584.00 to $10,025.00.
New Form Approving Special Needs Trust Accounting
Recently we received a document we haven’t seen before which informs Medicaid recipients that their special needs trust accounting was approved. Obviously, there is probably a different form telling some individuals that their accounting was not approved, but we haven’t seen that form yet. The new form is below:
SSI to Remove Food as In-Kind Support and Maintenance
On March 27, 2024, the Social Security Administration published a final rule in the Federal Register which changes its calculation of In-Kind Support and Maintenance (ISM). Under the prior rule, if food and/or shelter is provided to a recipient of Supplemental Security Income (SSI), the income is deemed to the recipient, reducing his or her […]
Is a Community Spouse required to name the State as remainder beneficiary of an annuity?
A Petition for writ of certiorari in the case of Dermody v. Massachusetts Executive Office of Health and Human Services is pending in the U.S. Supreme Court. The issue is “Whether an annuity that satisfies the condition in 42 U.S.C. § 1396p(c)(2)(B)(i) determining the Medicaid eligibility of a married institutionalized person must name the state […]
Georgia Medicaid Manual Updated with Transmittal 71
On November 17, 2023, Georgia issued Manual Transmittal 71, updating its Medicaid Manual, making technical changes to the following sections. The following sections were updated: 2054 – Emergency Medical Assistance 2060 – ABD Medicaid Application Processing 2101 – ABD Medicaid Classes of Assistance Overview 2111 – SSI Medicaid 2135 – Hospice Medicaid 2143 – QMB […]
Cost of Long-Term Care
For many years, Genworth has produced a Cost of Care Survey tracking the cost of long-term care in America. According to the survey, the projected national monthly median costs will be as follows: Homemaker Services: $5,417 Home Health Aide: $5,625 Adult Day Health Care: $1,847 Assisted Living Facility: $4,917 Nursing Home Semi-Private Room: $8,641 Nursing […]
2024 SSI and Spousal Impoverishment Standards Announced
On November 14, 2023, the Centers for Medicare and Medicaid Services announced the 2024 SSI and Spousal Impoverishment Standards. The SSI rate for 2024, which was previously announced by the Social Security Administration, will rise to $943. The Medicaid Income Cap will rise to $2,829. The minimum MMMNA will be $2,465 and the maximum MMMNA […]
2024 SSI Amounts and Estimated Impact on Medicaid
Effective January 1, 2024, the federal Supplemental Security Income payment amount will increase by 3.2 percent. The amounts paid to individuals and couples are below: Recipient Unrounded annual amounts for— Monthly amounts for 2024 2023 2024 a Eligible individual $10,970.44 $11,321.49 $943 Eligible couple 16,453.84 16,980.36 1,415 Essential person 5,497.80 5,673.73 472 Impact on Medicaid This […]
Medicaid Questions: Am I Eligible?
Am I Eligible for Medicaid? Recently we were asked about the following fact pattern. Parent had multiple properties in different counties. More than 60 months ago, parent gave these properties to children reserving a life estate. The question, initially, was whether parent is eligible for nursing home Medicaid. The follow-up question was whether the property […]
Medicaid Trust Case Remanded for Further Proceedings
Harves V. Rusyniak In Harves v. Rusyniak, 23A-PL-671 (9/26/2023), the Indiana Court of Appeals found that the Family and Social Services Administration (FSSA) missed a step in finding that a trust rendered Natalie Harves ineligible for Medicaid. Harnes and her children signed a number of documents in January 2019 when she was 91 years old. […]
